Role of dopamine agonists in Parkinsons Disease treatment
What is the role of dopamine agonists in the treatment of Parkinsons Disease?
Dopamine agonists directly stimulate dopamine receptors and, in contrast to levodopa, do not require enzymatic transformation into metabolites.
Because dopamine agonists bypass the presynaptic elements of the nigrostriatal system, they have some advantages in relation to levodopa.
For example, they cause dyskinesias and clinical fluctuations less frequently and usually have a levodopa-sparing effect.
The most established use of dopamine agonists is as an adjunct to levodopa, especially in patients with clinical fluctuations and dyskinesias.
Evidence indicates that early introduction of dopamine agonists delays the development of complications of levodopa therapy, such as motor fluctuations and dyskinesias, although this benefit may not be sustained.
After 10 years, there is no observable difference between patients initially treated with levodopa or a dopamine agonist with respect to levodopa-induced motor complications.